Provider Demographics
NPI:1770631731
Name:PERKINS DRUGS INC
Entity Type:Organization
Organization Name:PERKINS DRUGS INC
Other - Org Name:PERKINS DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:405-547-2414
Mailing Address - Street 1:820 N MAIN
Mailing Address - Street 2:
Mailing Address - City:PERKINS
Mailing Address - State:OK
Mailing Address - Zip Code:74059
Mailing Address - Country:US
Mailing Address - Phone:405-547-2414
Mailing Address - Fax:405-547-2995
Practice Address - Street 1:820 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PERKINS
Practice Address - State:OK
Practice Address - Zip Code:74059-4110
Practice Address - Country:US
Practice Address - Phone:405-547-2414
Practice Address - Fax:405-547-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
OK8-77353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2073581OtherPK
OK100238200AMedicaid